PKRP和PKEP治疗良性前列腺增生的对照研究  

A comparative study of PKRP and PKEP for the treatment of benign prostatic hyperplasia

作　　者：王春晖[1] 平秦榕 王英宝[1] 史云强[1] 龚瑞[1] 毕晓方[1] 熊杰[1] 李健[1] 钟一鸣[1] 李珲[1] WANG Chunhui;PING Qinrong;WANG Yingbao;SHI Yunqiang;GONG Rui;BI Xiaofang;XIONG Jie;LI Jian;ZHONG Yiming;LI Hui(Department of Urology,Yan′an Hospital Affiliated to Kunming Medical University,Kunming,Yunnan 650051,China)

机构地区：[1]昆明医科大学附属延安医院泌尿外科,昆明650051

出　　处：《重庆医学》2018年第32期4160-4163,共4页Chongqing medicine

基　　金：云南省卫生科技计划项目(2016NS316);云南省肿瘤免疫防治重点实验室开放课题(2017DG004-04);云南省卫生和计划生育委员会医学学科带头人项目基金(D-2017044);昆明市卫生科技人才培养项目暨"十百千"工程培养[2018-sw(省)-04]

摘　　要：目的探讨经尿道双极等离子前列腺切除术(PKRP)和经尿道双极等离子前列腺剜除术(PKEP)治疗良性前列腺增生(BPH)的有效性和安全性。方法回顾性分析2010年1月至2016年1月该院收治的877例BPH患者的临床资料,其中485例接受PKRP治疗,392例接受PKEP治疗。对比两组患者手术时间、术中出血、切除腺体质量、无需膀胱冲洗率、膀胱冲洗时间、留置导尿管时间、住院时间、手术并发症及国际前列腺症状评分(IPSS)和生活质量评分(QOL)等指标。结果 PKRP组与PKEP组患者的手术时间[(97.20±14.42)min vs.(59.47±13.10)min]、术中出血量[(103.72±20.43)mL vs.(50.19±17.11)mL]、膀胱冲洗时间[(2.61±0.74)d vs.(1.22±0.51)d]、留置尿管时间[(3.68±0.40)d vs.(1.52±0.58)d]、住院时间[(10.77±3.32)d vs.(7.23±1.11)d]比较,差异有统计学意义(P<0.05)。PKEP组切除腺体质量明显高于PKRP组[(62.73±15.10)g vs.(45.64±13.32)g,P<0.05]。PKEP组术后无需膀胱冲洗率显著高于PKRP组(65.05%vs.9.28%,P<0.05)。两组患者术后3个月IPSS和QOL均较术前明显降低(P<0.05)。PKEP组与PKRP组拔除尿管后第1天(30.10%vs.14.85%)、术后1周(18.62%vs.6.19%)和术后1个月(6.38%vs.2.06%)尿失禁发生率比较,差异有统计学意义(P<0.05)。结论 PKRP和PKEP均为治疗BPH安全、有效的方法,但PKEP在手术时间、术中出血、腺体剜除的彻底性和术后快速康复方面更具优势。Objective To compare the clinical efficacy and safety between transurethral bipolar plasmakinetic resection of the prostate(PKRP)and transurethral bipolar plasmakinetic enucleation of the prostate(PKEP)in the treatment of benign prostatic hyperplasia(BPH).Methods The clinical data of 877 cases with BPH treated in hospital from January 2010 to January 2016 were analyzed retrospectively.A total of 485 cases were treated with PKRP,while 392 cases received PKEP treatment.The operative time,intraoperative bleeding volume,resected tissue weight,no badder irrigation rate,badder irrigation time,indwelling catheter time,hospital time,complications,IPSS score and QOL score were compared between the two groups.Results The operative time[(97.20±14.42)min vs.(59.47±13.10)min],intraoperative bleeding volume[(103.72±20.43)mL vs.(50.19±17.11)mL],badder irrigation time[(2.61±0.74)d vs.(1.22±0.51)d],indwelling catheter time[(3.68±0.40)d vs.(1.52±0.58)d]and hospital time[(10.77±3.32)d vs.(7.23±1.11)d]in the PKRP group were significantly longer than those in the PKEP group(P<0.05).The resected tissue weight[(62.73±15.10)g vs.(45.64±13.32)g]and no badder irrigation rate(65.05%vs.9.28%)in the PKEP group were significantly higher than those in the PKRP group(P<0.05).The scores of IPSS and QOL at three months after operation decreased more than those before operation(P<0.05).The incidence of urinary incontinence in the PKEP group was significantly higher than that in the PKRP group(P<0.05)at the first day of indwelling catheter removal(30.10%vs.14.85%),one week postoperation(18.62%vs.6.19%)and one month postoperation(6.38%vs.2.06%).Conclusion Either PKRP or PKEP is a safe and effective method in the treatment of BPH,but PKEP has more advantages in the operation time,intraoperative bleeding volume,resected tissue weight and rapid postoperative recovery.

关 键 词：前列腺增生 双极等离子 前列腺切除术 前列腺剜除术 

分 类 号：R697.32[医药卫生—泌尿科学]